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Similaire à PPACA: Important Dates
Similaire à PPACA: Important Dates (20)
PPACA: Important Dates
- 2. Health Care Reform TimelineHealth Care Reform Timeline
Wright & Percy Insurance
• Temporary high risk pool
• Early retiree reinsurance program
• Small business tax credit
• Dependent coverage for adult children
until age 26
• No pre-existing condition exclusions
for individuals until age 19
• Rescissions prohibited except for
fraud or non-payment
• Lifetime dollar limits prohibited
• Annual dollar limits restricted
• Preventive services with no cost
sharing (G)
• Pediatricians as PCPs, direct access to
OB/GYNs (G)
• ER coverage as in-network, no prior
authorization (G)
• Appeals process and external review (G)
• Medicare Part D rebate for beneficiaries
in the gap
2010
• Annual rate review process
• Medical loss ratio (MLR): 85% for
large group; 80% for small group and
individual
• HSAs/HRAs/FSAs: limitations for OTC
medications
• Increase penalty for non-qualified
HSA withdrawals
• Small business wellness grants
• Annual fee on pharmaceutical manu-
facturers begins
• Discounts in Medicare Part D“donut
hole”
• Non discrimination rules apply to
insured plans (G) (implementation
delayed)
• Auto-enrollment for Groups with
200+ FTEs (implementation delayed)
2011 • Summary of Benefits and Coverage
and Uniform Glossary
• Expanded woman’s preventive
services (G)
• 60 day advance notice of material
modification
• Accountable Care Organization
requirements
• Quality bonus begins for Medicare
Advantage plans
• Comparative effectiveness fee ($1 per
member/year)
• Administrative simplification begins
• 1st medical loss ratio rebates to be
paid by August
2012
• Exchange notices to employees
• Employers to report value of employer-
sponsored health benefits on W2s
• FSA contributions limited to $2,500
• High earner tax begins
• Annual fee on medical device sales
begins
• Deduction for expenses to the Part
D subsidy for“qualified prescription
drug plans”eliminated
• Comparative effectiveness fee
increases to $2 per member/year
2013 • Health benefit exchanges
• Guaranteed issue and renewal rules (G)
• No annual limits
• No pre-existing condition exclusions
• Rating restrictions (G)
• Individual & employer mandates
• Tax credits and subsidies for individuals
and small employers
• Standardized essential health benefits
• Waiting period limit (90 days)
• Mandatory coverage for clinical trials (G)
• Reinsurance fee
• Annual insurance industry tax
• OOP limits must comply with OOP
limits for HSA qualified plans (G)
• Deductible caps cannot exceed $2k
for individual and $4k for family (G)
• ICD-10 code adoption
2014
• States can open Exchange to CHIP
eligibles (2015) and all employers
(2017)
• Sunset of comparative effectiveness
fee (2017)
• High-value plan excise tax“Cadillac
Tax”begins (2018)
• Insurance industry tax (through
2018)
• Medicare Part D“Donut hole”closed
(by 2020)
2015 &
BEYOND
(G) = Not applicable to grandfathered plans. Note: Some provisions apply only to fully insured plans. This is for informational purposes only and is not intended to be used as legal advice. BancorpSouth Insurance Services, Inc. is a wholly owned subsidiary
of BancorpSouth Bank. Insurance products are • Not a deposit • Not FDIC insured • Not insured by any federal government agency • Not guaranteed by the bank • May go down in value ©, 2013, BancorpSouth Insurance Services, Inc.
Rev. 2/8/2013